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Concepts in Hip Trauma

Dr Terence Dsouza, M.SDept of Orthopedics

Father Muller Medical College

Mangalore

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 Topics

• Hip dislocations

• Neck of femur fractures

•

ntertrochanteric fractures

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H! DS"OC#TONS

• !osterior dislocation$MC%$&T#'s%

  $Thompson (psteins Classi)cation%

•

#nterior dislocation• Central dislocation

• Hip dislocations *ith aceta+ular 's

•

Hip disocations *ith femoral head's$!ipkins%

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C"NC#" - / F(#T0&(S

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Methods of reduction

• Bigelo*s $not done, high risk of 's%

• Allis $usuall1 foll*ed%

•

Stimpsons gra2it1 method• East +altimore lift

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#llis - Stimpsons

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NOF

!au*els classi)cation3 importance44

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5ardens stages666

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Complications

• Osteonecrosis 7 non union 7 arthritis

• Osteonecrosis3

  Subcapital7 Transcer2ical7 +asal 

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8h1 non union in NOF

• ntracapsular 9 S/NO:#" F"0D;dilutes< #F

• No periosteal la1er

• !recarious +lood suppl1

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 Treatment of NOF

• = >?3 C&F or O&F

• 7@?3 Hemiarthroplast1

•

 >?;@?3 C&F A Hemi• !re eBisting arthritis3 TH&

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Osteos1nthesis for NOF 's

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0nipolar hemiarthrolast1

$ #M!AThompson's%

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ipolar hemiarthroplast1

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 TH&

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ra1

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Mc murra1 osteotom1

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T FCT0&(S

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CF

• (& lo*er lim+$ T7 NOF %

• Shortening$ T7 NOF%

•

 Tenderness at 5T$ NOF scarpastriangle%

• 0na+le to *alk$ ma1+e a+le to *alkin impacted NOF%

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!oints to remem+er

• Malunion$ MC%

•  Treatment 3

  !FN$ cephalomedullar1 nail%  DHS$ d1namic hip scre*%

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DHSA!FN